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Despite the controversy over the effectiveness of homeopathy, it is one of the complementary methods whose prevalence is increasing worldwide. Researching the reasons, as well as the health problems, for which people use homeopathy can provide answers for health care in general. The purpose of this study was to analyze the available publications and investigate the reasons for using the method among Bulgarians. A transversal survey was conducted among a sample of the Bulgarian population in 2022. A total of 555 completed surveys were received (women ‒ 486, men ‒ 69). Results. Over 90% of respondents used homeopathy. The main reasons for this are its effectiveness, holistic, individual approach and lack of side effects. Respondents used homeopathic treatment for a wide range of health problems encountered in general medical practice, with the largest proportion citing general health, respiratory, childhood, infectious and ear, throat and nose diseases. Allergies, skin, digestive and psychological problems are also often mentioned. A relatively small share of participants indicates more serious diseases such as cardiovascular, oncological and endocrine diseases. [ABSTRACT FROM AUTHOR]

Population aging is a difficult medico-social problem, which continues to be relevant to this day and still does not find a sufficiently adequate solution. This is due to the complex influence of a large number of factors on the state of health of people, the increased morbidity and mortality from both the common and relatively rare diseases. The diagnosis of acute pancreatitis is generally accepted based on acute abdominal pain consistent with the disease, more than three-fold elevations in serum lipase and/or amylase, and abdominal imaging, which is particularly helpful in atypical laboratory findings. The object of the present study were 29 patients with acute pancreatitis, 16 of whom are men and 13 women, hospitalized as an emergency and operated on in the Second Clinic of Surgery at the Department of Surgical Diseases at UMHAT „Sveta Marina“ – Varna. All hospitalized patients underwent routine clinical, laboratory and imaging tests. The following statistical methods were used for analysis and interpretation of the obtained data: alternative analysis, variation analysis, correlation analysis, univariate logistic regression analysis. We analyzed a constellation of indicators characterizing some of the important peculiarities of the diagnosis and treatment of these patients with an emphasis on the role of General Practitioners, with the aim of increasing the efficiency and improving the quality of medical care for this specific contingent of the population. The clinical picture of acute pancreatitis in the elderly differs from the typical one. A striking abrupt onset, with low-intensity epigastric pain and vomiting are key in diagnosing the disease. [ABSTRACT FROM AUTHOR]

Alcoholism does not limit on a certain group of the population but it is a problem of every social layer and age group. General practitioners have a key role in finding, diagnosing and tracking the people with alcohol dependence. The target of the preparing scientific research is ascertainment of the level of the alcohol consumption with a combined screening method, and also the frequency of the physical and mental damages because of it; and also development of a model for tracking and dispensary of the found dependent and risky people in the general practice. For the pilot investigation with 100 patient in Razgrad city a survey was developed, laboratory tests took place and hepatic ultrasound was performed. In the analysis of the results, the level of risky and alcohol dependent patients is very high – 42%, and a part of them are with newfound complications caused by the chronic alcohol disease. It is necessary during the prophylactic check-ups to be looked for manifests of abuse with alcohol and availability of the alcohol disease. That will allow early diagnosis and treatment of the ill and dependent people, and also protection from physical, mental and social defeats. [ABSTRACT FROM AUTHOR]

Abortion on demand, unfortunately, remains the main means of regulating unwanted pregnancy in Bulgaria today. There are many reasons for this. It is necessary to make a careful and thorough analysis of the objective reasons and to plan measures in this direction. [ABSTRACT FROM AUTHOR]

Introduction: One of our country's big problems is the deepening of demographic crisis leading to ageing and declining the number of population. This requires a detailed study of the causes and a proper strategy to prevent it. Aim: a study of some main indicators and trends related to birth rate and optional abortions in Bulgaria and Europe and the possibilities for optimizing them. Material: A documentary method has been used to assess literary sources on the issue of birth rate and abortion in Bulgaria and in Europe for a period of 15 years. Results: In our analysis, we identified a number of reasons for the demographic decline and progressive decrease in birth rates in our country over the past 15 years, which are also associated with an increase in optional abortions. Conclusions: It is necessary to develop an up-to-date national strategy for reducing optional abortions and stimulating the birth rate in Bulgaria, according to the established trends in Bulgaria. [ABSTRACT FROM AUTHOR]

In the 21st century there are rapid demographic and epidemiological changes, an ageing population, a growing burden of non-infectious chronic diseases, which are challenging in both rich and poor countries. Globally, now and in the future there will be huge pressure on health systems. This requires a skillful redirection of human, material and economic resources for adequate management with the rapidly changing needs and expectations of the population. This review deals with the idea of inter-professional cooperation and inter-professional education of dental medicine with other medical specialties and in particular its close collaboration with general medical practice. Data and analysis of available scientific medical literature on this issue and application of case studies of collaborative practices in different countries were used. It is considered that this will facilitate the policy and advocacy work undertaken by some national dental associations to plan the future workforce in the field of oral health and to improve the dental profession's ability to lead the change, rather than imposing solutions that are not always adequate. [ABSTRACT FROM AUTHOR]

The ability to communicate with the patient is at the core of good medical practice. Data from studies in recent years have shown an increase in serious diseases and malignancies worldwide, including oral cancer. Until now in Bulgaria, the topic "breaking bad news" has been taught only in medical students' training and in CME of family doctors. The authors present the essence of the ability to break bad news and the need for its introduction into dental students' training. The main prerequisites for this are the increase in malignant oral diseases and the work of most dental doctors in independent practices, which puts them in a state of stress if they do not have adequate training and skills. [ABSTRACT FROM AUTHOR]

Introduction: Urinary tract infections (UTIs) in childhood are a common problem in general medical and specialized pediatric practice. Their frequency and clinical manifestation depend on the sex, age of the child and the location of the inflammation, and the severity of the disease depends on the microbial virulence of the causative agent and the susceptibility of the host. With the increase in research methods in recent years, the early diagnosis of UTI has improved significantly, but the success of treatment and control does not depend only on the activity of GPs and pediatric nephrologists. For the early prevention and reduction of the recurrence rate, the knowledge, attitudes and practices of the parents who take care of their children on a daily basis play an essential role. One of the problems we face is the lack of adequate information on their part about UTI, which is not insignificant and sometimes leads to difficulties and delays in diagnosis and treatment. Aim of the study: to assess the knowledge, attitudes and practices of parents regarding the prevention of urinary tract infections in childhood. Methods: analysis of the scientific literature according to the PubMed and Google Scholar databases for a period of 20 years. Results: The analysis of the data from the scientific literature showed that parents do not know the symptoms of UTI in children except for the presence of cloudy or unpleasant-smelling urine. For other symptoms, they prevent the presence of a urinary tract infection. Many of them are not aware that UTI in childhood can have consequences in adulthood. They are often afraid of diagnostic procedures if they do not fully understand them and are worried about their child's diagnosis and prognosis. Children feel the fear of their parents and it can cause special harm when it leads to disagreement with research and proposed treatment. Delaying or avoiding a procedure due to fear can lead to greater risks to children's health than those associated with the procedure itself. Conclusions: Providing prior information to parents and, as appropriate, older children is very important for better compliance before and during treatment, as well as for the need for medical diagnostic and / or treatment procedures. [ABSTRACT FROM AUTHOR]

In the past, osteoarthrosis (OA) was considered as a non-inflammatory disease where the destruction of the hyaline cartilage is the leading cause of the functional disorders. The researches in this area had been focused mainly on the cartilage and the underlying bone. Today it is clear that OA is a pathological process that affects also the other structures of the joint apparatus (synovium, ligaments, joint capsule). Recent understandings define OA as a disease of the synovial joint with three main elements: cartilage loss, remodeling of the adjacent bone and concomitant low-grade inflammation, which has a major pathogenetic role in the joint damage. This is an aseptic type of inflammation, which is the result of the interaction between the immune system and the joint structures, leading to overproduction of cytokines and other pro-inflammatory molecules. Identifying the key participants in the low-grade inflammation will allow new therapeutic approaches to be established and give new abilities for slowing the progression of the destruction of the joints. [ABSTRACT FROM AUTHOR]

Older patients occupy an increasing proportion of the world population and, accordingly, the incidence of emergencies increases. Abdominal pain is the most common reason, for which older people seek medical attention. The clinical picture is very different from that in young patients and is often complicated or clouded by comorbidity and mental status. The incidence of gallstone disease rises sharply with age. The most common complication of cholelithiasis in the elderly and the elderly is acute cholecystitis. The subject of this study is a total of 45 patients with acute cholecystitis with a mean age of 71.50 ± 7.02 years (between 60 years and 88 years). It concerns 27 men and 18 women hospitalized as a matter of urgency and operated at the Second Surgery Clinic at the Department of Surgical Diseases at the Hospital of St. Marina EAD-Varna. All hospitalized patients underwent routine clinical, laboratory and imaging studies. The following statistical methods were used to analyze and interpret the data obtained: alternative analysis, variational analysis, correlation analysis, univariate logistic regression analysis. We analyzed a constellation of indicators characterizing some of the important features of diagnosing and treating these patients with a focus on the role of GPs in improving the effectiveness and quality of care of this specific population. [ABSTRACT FROM AUTHOR]

Ankylosing spondylitis (AS) is a chronic, progressing and debilitating disease of immune-mediated pathogenesis. Entheses, the sacroiliac and apophyseal joints are the primary foci of inflammation. The clinical manifestations of AS include pain and rigidity in the sacral region and along the spine, deteriorated quality of life, reduced functional capacity. Among all rheumatoid diseases, AS has the longest diagnostic delay. It has been ascertained that the time from the onset of the symptoms until the diagnosing of AS is between 8 and 11 years in Europe and approximately 13 years in the USA. The review examines the main reasons for the diagnostic delay and the consequences from it. The emphasis is on the role of the GP in the strategy for early diagnostics of AS and avoiding of a structural damage. We offer a questionnaire prepared by us to help GPs regarding the timely referral to rheumatologist of a patient with clinical complaints from the musculoskeletal system and probability of existence of inflammatory arthritis. [ABSTRACT FROM AUTHOR]

The diabetics fall into the risk group of peritoneal dialysis patients. Different types of complications like hypertension, IHD (ischemic heart disease), left ventricular hypertrophy, arrhythmia, orthostatic hypotension, obliteration of blood vessels, diabetic retinopathy, dyslipidemia, etc., are already present by the start of renal replacement therapy. In this review, we discuss the differences in treating diabetic patients by peritoneal dialysis. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a systemic chronic inflammatory disease of unknown etiology characterized by pain, stiffness and swelling of the joints due to inflammation of the synovium. А number of different interleukins and inflammatory cells play a role in the joint inflammation that leads to the formation of erosions in the subchondral bone with subsequent joint destruction. This is a disease with autoimmune genesis, as antibodies are produced in the body and attacking their own structures. The major antibodies are different fractions of rheumatoid factor (IgA, IgM, IgG), anti CCP, anti MCV. The presence or absence of these antibodies can be used for both diagnostic and prognostic criteria of the disease as it has been shown that patients with positive RF and/or presence of anti-CCP antibodies are at a higher risk of developing erosions and functional disorders, which determines the need for faster and more aggressive treatment. The disease has a different activity in individual patients. The evaluation of this activity makes it possible to assess the progression of the disease and the applied treatment response. Different methods have been introduced for this purpose and they can be divided into three main groups: clinical, radiographic and laboratory. [ABSTRACT FROM AUTHOR]

The low back pain is amongst the most common reasons for physician office visits. It is a main problem of the public health in the developed countries and leads to huge economic loss. In the paper the specific clinical features, deriving from affecting different anatomic structures, leading to non-specific low back pain, are included. The paper also highlights the role of the physical factors in the treatment. The competent diagnostic and therapeutic approach in patients suffering from low back pain has a decisive role for preserving the work capacity of the affected individuals. The accurate diagnosis provides an opportunity for developing the right treatment plan. The treatment of the pain syndrome in the lumbar area should be complex and consistent with the stage of the disease. The goal is to achieve optimal physical, psychological and behavioral recovery of the affected individuals. In the acute stage the drug treatment has the main role. In the subacute and chronic stages conservative means of treatment are also used. In those stages is appropriate to use physiotherapy and kinesiotherapy. An adequately conducted treatment is a premise for reducing the economic loss for the society and better quality of life. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) is a chronic inflammatory disease that occurs with joint damage and destruction. In addition to being a diagnostic criterion, the x-ray can be followed over time, thus detecting the disease progression. It was found that the most pronounced X-ray changes were observed in the first years after the diagnosis has been made, especially for untreated patients. Numerous studies have shown that joint damage correlates with the duration and activity of the disease. In recent years, we have witnessed significant changes in the therapy of RA, as the use of biological disease-modifying anti-rheumatic drugs (bDMARDs) has been introduced in practice. Evaluating patients with regard to the available radiographic changes at the beginning and after a defined treatment period can be done to objectify the effect of this treatment on the radiographic progression of the disease. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (PA) is systemic chronic inflammatory disease with unknown etiology and autoimmune genesis. Its course depends on the individual characteristics of the patient, external factors and/or factors associated with treatment. Early onset of medication is crucial to achieve positive long-term effect. However, in a proportion of patients, despite the treatment, there is a persistence of high clinical and laboratory activity. It is difficult to determine the individual course of every patient with RA at the outset, but there are some factors that are associated with an unfavorable prognosis in regard to joint damage and patients’ disability. Establishing them allows differentiation the group of patients with worse prognosis for disease progression and early disability. Those cases require early aggressive treatment, including biological disease-modifying drugs to suppress inflammatory activity and stop rapid destruction of the joints. [ABSTRACT FROM AUTHOR]